Tennis Elbow Treatment Overview

The main cause of tennis elbow is overuse and repetitive stress on the forearm muscles and tendons. Over time, repeated gripping, lifting, or twisting can create micro-injuries and degeneration instead of healing. Though the injury is famous among tennis players (hence the name), it is actually more common in jobs and activities involving:

• Repetitive wrist extension (lifting hand upward)

• Repetitive gripping or twisting of the forearm

• Playing tennis, squash, or racquet sports (improper backhand grip, wrong tennis grip, or poor racket technique)

• Carpentry, painting, plumbing, or any manual labor

• Prolonged use of a computer mouse (lateral movements) or keyboard

Risk factors include:

• Age: Most often affects adults aged 35–54, but can occur at any age

• Occupation: Plumbers, carpenters, painters, butchers, cooks, musicians, and hairdressers

• Sports and activities: Tennis (especially improper technique), golf, weightlifting, and other sports requiring repetitive arm motion

• Lack of conditioning/poor technique (tennis elbow is more common in recreational players than in pros)

• Smoking, obesity, and certain medical conditions like diabetes may impair healing

Contrary to myth, you don’t have to play tennis or sports to get tennis elbow—it’s the repeated use and microtrauma, not just tennis itself.

Recognizing tennis elbow symptoms is crucial for early treatment and recovery.

• Pain and tenderness: Localized on the outer or lateral side of your elbow (lateral epicondyle)

• Pain radiates down the outer forearm, occasionally as far as the wrist and hand

• Pain worsens with:

  • Gripping (e.g., holding a racket, screwdriver, paintbrush, or coffee mug)

  • Lifting objects, especially with the palm facing down

  • Twisting (e.g., opening a jar, shaking hands, wringing laundry)

  • Bending or straightening the elbow

• Forearm weakness: Difficulty holding or lifting objects, weak grip strength

• Stiffness: Especially in the morning or after periods of rest

• Possible swelling or a visible “bump” over the lateral epicondyle

The pain of tennis elbow is usually described as dull and aching but can sometimes be sharp when using the arm. In most cases, rest temporarily relieves the pain, but symptoms return with resuming activity.

Note: Tennis elbow affects the outside (lateral side) of the elbow. If your pain is on the inside, it may be “golfer’s elbow” (medial epicondylitis).

How Is Tennis Elbow Diagnosed?

A healthcare provider will usually diagnose tennis elbow based on your symptoms and a physical examination:

• Palpation: Tenderness at the lateral epicondyle

• Resistance tests:

  • Cozen’s test: Pain when you straighten your wrist against resistance

  • Mill’s and Maudsley’s test: Pain triggered by stretching/wrist extension

• Range of motion: Although movement may produce pain, normal range is usually preserved

Imaging is not always needed but may be used to rule out other injuries or causes:

• X-ray: To rule out arthritis or fractures

• Ultrasound or MRI: Shows tendon degeneration, tears, or swelling for complex cases

When to see a doctor:

• Symptoms persist for more than 2–3 weeks

• Marked swelling, loss of movement, numbness, or trauma

• Symptoms worsen or interfere with daily life

Self-diagnosis should not replace a proper medical consultation.

Several other conditions cause elbow pain and can mimic tennis elbow:

• Golfer’s elbow (medial epicondylitis): Pain on the inner elbow

• Radial tunnel syndrome: Nerve compression causing overlapping symptoms

• Elbow bursitis: Swelling behind the elbow point (olecranon bursa)

• Osteoarthritis or rheumatoid arthritis

• Elbow sprain or strain

• Pinched nerve in the neck or shoulder

• Tendonitis in other elbow tendons

Why does this matter?
Accurate diagnosis ensures proper treatment. For example, treatment of ulnar nerve entrapment (cubital tunnel syndrome) differs from tennis elbow strategies.

Home Care & Self-Management

In most cases, tennis elbow can be treated successfully without surgery. Key strategies include:

Rest:
Stop or cut back on activities causing symptoms but avoid total inactivity, which may weaken muscles further.

Icing/Cold Packs:
Apply ice to the outer elbow for 15–20 minutes, 3–4 times a day during the first few weeks.

Over-the-counter medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can relieve pain and swelling. Topical anti-inflammatory creams or gels are an alternative for some.

Modern physiotherapy: effective exercises for tennis elbow recovery

Braces & Straps:
A tennis elbow brace (counterforce brace) or tennis elbow strap helps by reducing tension on the tendon. Wear during aggravating activity, not 24/7.

Gentle Exercises for Tennis Elbow
Once pain diminishes, start gentle stretching and then forearm muscle strengthening.
Common stretches and exercises include:

• Wrist extension and flexion

• Eccentric wrist extension strengthening

• Forearm pronation/supination

• Grip strengthening (squeeze a soft ball)
  See below for more detail on prevention and exercise techniques.

Avoid:
Heavy lifting, gripping, or twisting during pain flares. Don’t “push through” severe pain.

Non-Surgical Interventions

Physical therapy:
Evidence strongly supports physiotherapy for tennis elbow. Key elements:

• Manual therapy (massage and mobilization)

• Guided strengthening and stretching (focus: wrist extensors, grip)

• Education about movement and workplace ergonomics

• Ultrasound therapy or laser therapy may be beneficial for some

Other therapies:

• Shockwave therapy (ESWT): May stimulate healing in chronic cases

• Steroid injections: Often provide rapid pain relief in the short term but are not recommended for long-term benefit (may weaken tendon over time)

• Platelet-rich plasma (PRP): Mixed evidence, may be considered for chronic cases after usual care

• Dry needling or TENEX tenotomy: Being studied for persistent cases

Surgical Options

Surgery is reserved for severe symptoms unresponsive to 6–12 months of comprehensive non-operative treatment.

• Open or arthroscopic tendon debridement: Removing damaged tendon tissue

• Repair or reattachment of extensor tendon to bone

• Post-surgical rehabilitation: Essential for regaining strength and flexibility

Outcomes:
Surgical success rates are high when performed for appropriate indications, but most people recover with nonsurgical approaches.

In the United Kingdom, tennis elbow surgery—usually performed as a day-case “lateral epicondyle release”—is available both through the NHS (subject to waiting times and eligibility) and privately. For private treatment, prices start arou

Orthopedic surgeons in the UK providing expert care for tennis elbow

nd £2,949 at leading specialist clinics across the UK, with costs generally ranging from £2,900 to £6,000 depending on location and the chosen provider.

For example, Practice Plus Group and other top private hospitals in cities like London, Southampton, Plymouth, and Gillingham consistently offer tennis elbow surgery at this rate. Surgery is typically performed with either local or general anesthesia, takes 15–30 minutes, and most patients return home the same day. Private medical insurance plans can help cover the procedure, or patients may self-pay for fast access and reduced wait times.

Many patients from the UK and Western Europe choose to travel to Turkey or Poland for tennis elbow surgery, attracted by substantial cost savings without compromising quality and safety. In Turkey, fully inclusive prices for tennis elbow surgery typically range from $4,500 to $6,000, with luxury clinics in Istanbul, Ankara, and Antalya offering modern facilities, English-speaking staff, airport transfers, and post-operative care as part of comprehensive packages. The lower costs are made possible by exchange rates, lower living expenses, and government incentives for medical tourism.

Visit Istanbul for affordable and high-quality tennis elbow treatment

In Poland, surgical treatment of tennis elbow generally costs between 1,500 PLN and 3,900 PLN (about €350-€900, or £300-£750), with state-of-the-art clinics in cities such as Warsaw and Kraków. Advanced orthopedic clinics like KCM in Poland list all-inclusive tennis elbow surgery at around €2,600.

If you are considering surgery abroad, it is essential to secure adequate medical travel insurance. Clinic Hunter offers specialized insurance policies tailored to patients traveling for medical procedures. This insurance can cover complications, cancellations, medical repatriation, extensions of stay, and even a companion’s return. While it does not reimburse the cost of a planned procedure, it provides peace of mind in case of unforeseen events or emergencies during your treatment journey. Policies are conveniently available online directly from Clinic Hunter.